新疆伊犁地区妊娠期糖尿病发病危险因素及妊娠结局

Analysis of risk factors and pregnancy outcomes of women with gestational diabetes mellitus in Yili region of Xinjiang

目的:调查新疆伊犁地区妊娠期糖尿病(GDM)患病情况、危险因素及妊娠结局。方法:采用系统整群抽样法抽取新疆伊犁地区4所医院建档并接受规范产前检查的单胎孕妇6434例,按2010年国际糖尿病与妊娠研究组(IADPSG)制定的GDM新诊断标准筛查GDM。分析GDM患病特征并随访妊娠结局。结果:该地区GDM患病率为6.6%(422/6434),年龄≥35岁、DM家族史、孕前超重或肥胖、接受高等教育、经产妇、城镇户籍及脑力劳动均是GDM患病的独立危险因素(P<0.05)。GDM组分娩孕周早于非GDM组,剖宫产率、早产、贫血、妊娠期高血压疾病、羊水过多率均高于非GDM组,且血糖控制不良组高于血糖控制组(均P<0.05);胎膜早破、产后出血与非GDM组比较无差异(P>0.05)。GDM组大于胎龄儿、胎儿生长受限、巨大儿及新生儿低血糖发生率高于非GDM组,且血糖控制不良组高于血糖控制组(均P<0.05),胎儿窘迫、先天畸形率GDM组与非GDM组无差异(P>0.05)。结论:新疆伊犁地区GDM患病率居我国中等水平,患病率有人群差异,应针对性采取特色干预及孕期管理措施防治GDM,提高孕产妇保健水平。

Objective:To investigate the prevalence and risk factors of gestational diabetes mellitus(GDM)in Yili region of Xinjiang,and to analyze its influence on pregnancy outcomes.Methods:4 hospitals in Yili region of Xinjiang were selected by systematic and cluster sampling method.Clinical data of 6434 pregnant women who attended prenatal care and delivered in these four hospitals were collected.GDM was diagnosed according to International Association of Diabetes and Pregnancy Study Groups(IADPSG).The disease characteristics of GDM were analyzed and the pregnancy outcomes of all included pregnant women were followed up.Results:The prevalence of GDM in Yili region was 6.6%(422/6434).The age≥35 years old,family history of diabetes mellitus,pre-pregnancy overweight or obesity,high education level,maternal,urban household registration,or mental work were the independent risk factor for GDM(P<0.05).The the delivery gestational weeks of women with GDM was earlier than that of women without GDM(P<0.05).The rates of cesarean section,premature labor,anemia,hypertensive disorder complicating pregnancy(PHD),and hydramnios of women with GDM were significant higher than those of women without GDM,and those of GDM women with poor glycemic control were also significant higher than those of GDM women with good glycemic control(P<0.05).There were no significant different in rates of premature rupture of membranes and postpartum hemorrhage between the women with GDM and the women without GDM(P>0.05).The incidences of fetus with large for gestalional age(LGA),fetal growth restriction(FGR),macrosomia,and hypoglycemia of neonates of women with GDM were significant higher than those of women without GDM,and those of GDM women with poor glycemic control were also significant higher than those of GDM women with good glycemic control(P<0.05).There were no significant different int the incidences of fetal distress and congenital malformation between the women with GDM and the women without GDM(P>0.05).Conclusion:The prevalence of GDM in Yili region of Xinjiang was at middle intermediate level of China and has population differences.It should be improved the level of perinatal healthcare of women from Yili region by targeted management measures for preventing GDM.